Internal Comparison Research Articles

Measuring service quality based on consumers’ evaluation of services in competitive markets

Previous research recommends using measurement models of service quality such as SERVQUAL and SERVPERF. However, these models may be insufficient for measuring service quality in competitive markets, as they do not account for comparisons between competitive services. This paper proposes a new model for measuring service quality based on two comparison processes that consumers use: internal and longitudinal comparison versus external and cross-sectional comparison. The former involves comparing the experienced quality to the expected quality of a focal firm, while the latter involves comparing the experienced quality of the focal firm and that of other firms. This paper shows that internal and longitudinal comparison significantly influences customer satisfaction through external and cross-sectional comparison. It also highlights the advantages of the new model and advocates for its use in competitive markets. By comparing these dual comparison processes, the proposed model offers a more comprehensive and nuanced understanding of service quality assessment in competitive market environments.

Intensified greenhouse gas prediction: Configuring Gate with Fine-Tuning Shifts with Bi-LSTM and GRU System

IntroductionOn a global scale, climate change refers to persistent alterations in weather conditions and temperature patterns. These modifications have far-reaching implications across the world. GHGs (Greenhouse Gases) play a crucial role in driving climate change. Most of these emissions originate from human activities, particularly those contributing to releasing CO2 and CH4. In the conventional approach, identifying emissions involves recognizing and quantifying the sources and amounts of GHG released into the atmosphere. However, this manual identification method has limitations, including being time-consuming, relying on incomplete resources, prone to human error, and lacking scalability and coverage.MethodologyTo address these challenges, a technology-based system is necessary for effectively identifying GHG emissions. The proposed method utilized the configuration of a gating mechanism incorporating fine-tuning shifts in the Bi-LSTM-GRU algorithm to predict GHG emissions in top-emitting countries. The PRIMAP-host dataset is used in the respective method comprising subsector data such as CO2, CH4, and N2O to attain this. In the presented model, Bi-LSTM is used to capture significant features, handle vanishing gradient problems, etc., because of its process in both directions. Conversely, it is limited by overfitting and long-term dependencies.Results and discussionGRU is used with Bi-LSTM to address the issue for the advantages of memory efficiency, handling long-term dependencies, rapid training process and minimizes the overfitting by infusion of GRU in the input layer of BiLSTM with tuning process in the BiLSTM. Here, the configuration of gates with fine-tuning shifts to improve the prediction performance. Moreover, the efficiency of the proposed method is calculated with performance metrics. Where RMSE value is 0.0288, MAPE is 0.0007, and the R-Square value is 0.99. In addition, internal and external comparisons are carried out to reveal the greater performance of the respective research.

Conspectus of the vegetation types of Tajikistan and adjacent areas with special focus on phytosociological classes

Vegetation classification is a tool for organizing the patterns and diversity of plant communities. It is used in nature conservation, and helps to understand the role of vegetation in the biosphere. Given the rapidly diminishing opportunity to understand the vegetation diversity of Tajikistan located in the Middle Asian region, phytosociological surveys using the floristic-ecological approach and the Braun-Blanquet cover-abundance scale were undertaken in 2006. Aer 18 years of research, with a total of 55 research expeditions to Tajikistan, Kyrgyzstan, and Uzbekistan, it is time to summarise and make a first attempt to establish a comprehensive classification system for the entire vegetation of Tajikistan and the surrounding areas. As a first step, the Vegetation of Middle Asia (VMA) database with records from three countries: Tajikistan (4,130 relevés), Kyrgyzstan (1,681 relevés) and Uzbekistan (13 relevés) was created. e internal comparison of all the plots and the analysis of the similarities with the vegetation of Iran, Russia, Afghanistan, Mongolia, Pakistan, and China make it possible to present the comprehensive list of plant communities organized in 45 classes, 47 orders, 83 alliances, 297 associations, and 237 rankless units. In addition to those described in our previous works, we propose also several new sytaxa: <i>Eremogono griffithii-Nepetetea podostachyos, Artemisio persicae-Stipetea drobovii, Festucetea alaico-krylovianae, Carici koshewnikowii-Asperuletea oppositifoliae, Trichodesmo incani-Pachypterygietea brevipes, Aceretalia turkestanici, Juniperetalia seravschanicae, Crataegetalia ponticae, Populetalia pruinoso-euphraticae, Salici capusii- Hippophaeetalia rhamnoidis, Carici stenophylloidis-Stipetalia drobovii, Eritrichion pamirico-subjacquemontii, Stipetum kazachstanicae, Caricetum pamirensis</i>, and <i>Bolboschoenetum affinis</i>. Tis systematic compilation of data, based on our fieldwork and literature data, is not definitive, and certainly the rich and diverse vegetation of Middle Asia requires further studies incorporating also modern LIDAR and satellite techniques.

Repetitive transcranial magnetic stimulation (rTMS) in the treatment and diagnosis of eating disorders in athletes and patients: a systematic review

Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive technique used to treat and diagnose eating disorders (EDs) by targeting brain regions like the dorsolateral prefrontal cortex, which is involved in impulse control and emotion regulation. Particularly beneficial for athletes, rTMS can reduce symptoms of EDs. Therefore, this study aimed to carry out a systematic review of the scientific literature on the therapeutic or diagnostic use of rTMS in athletes and patients with EDs, with an emphasis on binge eating disorder (BED), anorexia nervosa (AN), and bulimia nervosa (BN). A literature survey was carried out in the Directory of Open Access Journals (DOAJ), Medline, Directory of Open Access Scholarly Resources (ROAD), Academic Search Premier, Wiley-Blackwell Full Collection, Nature Open Access, BioMed Central Open Access, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). A total of 26 original papers published until November 21, 2021, were included. The selected studies were grouped for each respective protocol: total number of patients or athletes, sociodemographic aspects of the participants, parameters performed in rTMS: type of coil, intensity, frequency, number of pulses, stimulation site, preliminary results, and incidence of adverse effects. Recent evidence suggests a low rate of side effects with the technique and a substantial high frequency rTMS response in both the dorsolateral prefrontal cortex and the ventromedial region, especially in studies where internal comparison was performed. The great tolerance and safety of neuromodulatory treatment with rTMS encourage the application of the technique, especially in patients with refractory eating disorders. In addition to the therapeutic potential, rTMS is an essential diagnostic tool in elucidating the complex neurobiology of eating disorders. A more significant increase in publications on the subject is expected in a controlled, blind, and randomized manner, leading to a homogenization of results and generalization of its potential use. Keywords: Eating disorders, Neurology, Neuromodulation, Psychology, Psychiatry, Noninvasive brain stimulation.

Predicting clinically significant prostate cancer in elderly patients: A nomogram approach with shear wave elastography.

This study was to construct a nomogram utilizing shear wave elastography and assess its efficacy in detecting clinically significant prostate cancer (csPCa). 290 elderly people with suspected PCa who received prostate biopsy and shear wave elastography (SWE) imaging were respectively registered from April 2022 to December 2023. The elderly participants were stratified into two groups: those with csPCa and those without csPCa, which encompassed cases of clinically insignificant prostate cancer (cisPCa) and non-prostate cancer tissue, as determined by pathology findings. The LASSO algorithm, known as the least absolute shrinkage and selection operator, was utilized to identify features. Logistic regression analysis was utilized to establish models. Receiver operating characteristic (ROC) and calibration curves were utilized to evaluate the discriminatory ability of the nomogram. Bootstrap (1000 bootstrap iterations) was employed for internal validation and comparison with two models. A decision curve and a clinical impact curve were employed to assess the clinical usefulness. Our nomogram, which contained Emean, ΔEmean, prostate volume, prostate-specific antigen density (PSAD), and transrectal ultrasound (TRUS), showed better discrimination (AUC = 0.89; 95% CI: 0.83-0.94), compared to the clinical model without SWE parameters (p = 0.0007). Its accuracy, sensitivity and specificity were 0.83, 0.89 and 0.78, respectively. Based on the analysis of decision curve, the thresholds ranged from 5% to 90%. According to our nomogram, biopsying patients at a 20% probability threshold resulted in a 25% reduction in biopsies without missing any csPCa. The clinical impact curve demonstrated that the nomogram's predicted outcome is closer to the observed outcome when the probability threshold reaches 20% or greater. Our nomogram demonstrates efficacy in identifying elderly individuals with clinically significant prostate cancer, thereby facilitating informed clinical decision-making based on diagnostic outcomes and potential clinical benefits.

Anticoagulation in embolic acute limb ischaemia-an observational study.

The management of embolic acute limb ischaemia commonly involves determining aetiology and performing emergency invasive procedures. This detailed study aimed to determine the impact of manipulation of anticoagulation in the aetiology of emboli in acute limb ischaemia and determine the efficacy of primary anticoagulation therapy vs. invasive interventions. Material and methods: Data collection was conducted at a single institution on a cohort of patients presenting consecutively with embolic acute limb ischaemia over one year. Two groups were compared, one receiving anticoagulation as primary therapy with those undergoing invasive treatment as the internal comparison group. Results: A likely haematological causation was identified in 22 of 38 presentations, related to interruption of anticoagulation in cardiac conditions, the majority atrial fibrillation (n=12), or hypercoagulable states (n=10). Limb salvage was pursued in 36 patients employing anticoagulation (n=19) or surgical embolectomy (n=17) as the primary therapy in upper and lower limbs (n=17 vs n=19 respectively). Despite delays often well beyond six hours and a range of ischaemic severity in both groups, 35 of 36 patients achieved full or substantive restoration of function with improved perfusion. Regarding anatomical distribution of arterial disease and therapy, three patients with multi-level disease proceeded to embolectomy following anticoagulation. Embolectomy was undertaken most often for proximal emboli and more profound paralysis. Conclusions: Anticoagulation and coagulopathy are commonly implicated in the aetiology of arterial emboli, with omission of effective anticoagulation in atrial fibrillation being associated in almost 1/3 of presentations. Whilst more profound limb paralysis and proximal or multi-level disease tended to be managed surgically, primary anticoagulation therapy alone or with a secondary embolectomy was effective across the spectrum of ischaemia severity and despite significant delays beyond guideline recommendations.

Comparison of modeling methods for the effective diffusivities of IO3 − estimated in compacted bentonite using through-diffusion tests under aerobic conditions

Abstract Diffusion is the predominant mechanism governing the transport of 129I through geosphere. Consequently, the assessment of the experimental findings on two-compartment diffusion reservoirs of IO3 − within compacted bentonite involved the application of three distinct diffusion models: CC–CC (constant concentration), CC–VC (variable concentration), and VC–VC. To ensure the reliability of the obtained diffusion coefficients, multiple laboratory tests were performed for internal comparison. The experimental results revealed that IO3 − diffusion coefficients were ranging from 3.83 × 10−13 to 1.91 × 10−11 m2/s. These techniques using three mathematical models could be conducted to estimate the diffusion coefficients of non- or weakly-sorbing radionuclides on compacted bentonite for safety assessment of radioactive waste final disposal.

Accurate characterisation of optical diffuse transmission—primary facility and extension to translucent samples

To perform accurate, high-quality and traceable measurement of optical diffuse transmission, which is quantified using the bidirectional transmittance distribution function (BTDF), a new primary facility has been developed at the Physikalisch–Technische Bundesanstalt (PTB), the German metrology institute. This newly developed reference facility will complement the available calibration services and research facilities at PTB for regular reflectance and transmittance and diffuse reflectance. The performance of the new BTDF setup has been investigated in an internal comparison, where consistency of the results was achieved. A thorough uncertainty analysis results in a minimum combined standard (k = 1) uncertainty of about 0.8 %. Research on the accurate characterisation of the BTDF of samples with non-negligible lateral scattering is being carried out on this new setup. Some first results have shown that the measured BTDF value depends on the applied irradiation area size. An empirical model has been found to describe the diffuse transmission of such translucent samples with different scattering parameters.

Comparison of internal and external reference populations for occupational cancer surveillance in a cohort drawn from a diverse workforce.

Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program. A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario. SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal. Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.

Academic Benchmarking and the Provision of Quality Secondary Education in Tanzania

The study explored the use of academic benchmarking in the provision of quality education in Tanzania secondary schools. The study found that the ABM process plays a significant role in ensuring the provision of quality education through internal assessment, comparisons, and adoption of best practices from benchmarked schools. The findings disclosed that the secondary education system in Tanzania uses academic benchmarking to inform decision-making. Further, the findings disclose that six types of academic benchmarking are utilised in Tanzanian secondary schools. The study concludes that the academic benchmarking process enhances the provision of quality education since it affects future performance and commitments to work on the goals, vision and mission of secondary schools. Furthermore, academic benchmarking helps to make comparisons and sustain school performance.

Spectrophotometrically derived seawater CO2‐system assessments: Parameter calculations using pH do not require measurements at standard temperatures

AbstractThe temperature range of Earth's open‐ocean waters is roughly 0–30°C, yet our understanding of the seawater carbon dioxide (CO2) system is largely derived from analyses conducted within a narrow temperature range (e.g., laboratory temperature of 20°C or 25°C). Herein, we address two aspects of open‐ocean CO2‐system measurements and modeling: (1) a highly precise spectrophotometric technique is used to determine bicarbonate dissociation constants (K2) in seawater at temperatures as low as 3°C and (2) a cruise dataset uniquely including total scale pH measurements at two temperatures is used for CO2‐system internal consistency comparisons at 12°C and 25°C. Our pK2 parameterization (where pK = −log K) is applicable for broad ranges of salinity (20 ≤ SP ≤ 40) and temperature (3°C ≤ t ≤ 35°C). Our CO2‐system internal consistency evaluation (comparison of measured and calculated CO2‐system parameters) utilized data obtained during NOAA's 2021 West Coast Ocean Acidification Cruise: total alkalinity (TA), total dissolved inorganic carbon (DIC), pH measured at 25°C, and pH measured at 12°C (n = 265). Results demonstrate that, relative to calculations utilizing the TA, DIC pair, agreement between measured and calculated parameters is improved when either TA or DIC is paired with pH measurements at either temperature. Calculations of CO2 fugacity (fCO2) and aragonite saturation state (Ωar) using pH measurements made at 25°C or 12°C (paired with either TA or DIC) are statistically indistinguishable. Results also suggest that the temperature dependence of current CO2‐system dissociation constants need further refinement.

Impact of Time on Parameters for Assessing the Microstructure Equivalence of Topical Products: Diclofenac 1% Emulsion as a Case Study.

The demonstration of bioequivalence proposed in the European Medicines Agency's (EMA's) draft guideline for topical products with the same qualitative and quantitative composition requires the confirmation of the internal structure equivalence. The impact of the shelf-life on the parameters proposed for internal structure comparison has not been studied. The objectives of this work were: (1) to quantify the effect of the time since manufacturing on the mean value and variability of the parameters proposed by the EMA to characterize the internal structure and performance of topical formulations of a complex topical formulation, and (2) to evaluate the impact of these changes on the assessment of the microstructure equivalence. A total of 5 batches of a topical emulgel containing 1% diclofenac diethylamine were evaluated 5, 14, and 23 months after manufacture. The zero-shear viscosity (η0), viscosity at 100 s-1 (η100), yield stress (σ0), elastic (G') and viscous (G″) moduli, internal phase droplet size and in vitro release of the active ingredient were characterized. While no change in variability over time was detected, the mean value of all the parameters changed, especially the droplet size and in vitro release. Thus, combining data from batches of different manufacturing dates may compromise the determination of bioequivalence. The results confirm that to assess the microstructural similarity of complex formulations (such as emulgel), the 90% confidence interval limit for the mean difference in rheological and in vitro release parameters should be 20% and 25%, respectively.

Multiple salary comparisons, distributive justice, and employee withdrawal.

Salary comparison has well-established implications for employees' attitudes and behaviors at work. Yet how employees process information about simultaneous comparisons, particularly when internal and external comparison information is incongruent, remains controversial. In this article, we draw from the model of dispositional attribution and equity theory to predict how the incongruence of internal and external salary comparisons affects perceptions of distributive justice and subsequent employee withdrawal behavior. We hypothesized that the effect of salary comparisons on perceived distributive justice follows a hierarchically restrictive schema in which a lower salary in comparison to a referent has a greater effect than a higher salary. This further affects employee withdrawal (neglect, turnover intention, and voluntary turnover). We also propose that the effects of salary comparisons are bounded by employees' zero-sum construal of success. Three studies were conducted to test our hypotheses: a quasi-experimental study and two time-lagged field studies. Consistent with our hypotheses, we observed that, when comparison information was incongruent, underpayment compared with others more strongly affected perceived distributive justice than overpayment did. The subsequent impact on perceived distributive justice was negatively related to employee withdrawal. As expected, the effect of incongruent salary comparison information was stronger for employees with lower zero-sum construal of success. The theoretical and practical implications of these findings are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Role of “Likes” and “Dislikes” in Influencing User Behaviors on Social Media

ABSTRACT Two recent changes on social media platforms include (1) allowing users to mask the number of “likes” on others’ posts, aimed at reducing social comparisons and consequent technology-mediated dangerous behaviors (TMDBs), such as disclosing private information, and (2) adding a “dislike” reaction, aimed at increasing engagement. Nevertheless, the effects of these changes on user behaviors are unclear. In this paper, we seek to address this gap by integrating risk-sensitivity theory (RST) and prospect theory. First, we explain that while masking others’ “likes” may reduce social comparison, based on the “homeostatic violation” concept, people also make internal comparisons to expectations. Undesirable deviations from users’ expectations of “likes” and “dislikes” (e.g., too few “likes” or too many “dislikes”) can motivate TMDBs that users believe can alleviate the undesirable deviations. Thus, we argue that, in addition to social comparison mechanisms, there is an internal comparison mechanism that can motivate TMDBs. We test these claims via five randomized controlled experiments (total n = 1,594). Results show that, beyond social comparison mechanisms, receiving too few “likes” or too many “dislikes,” compared to internal expectations, can motivate TMDBs. Moreover, we found that losses loom larger than gains as users are more likely to engage in TMDBs to avoid excess “dislikes” than to avoid deprivation of “likes.” These findings make novel contributions to social media research and practice by pointing to an internal comparison mechanism as a potent motivator of TMDBs beyond social comparison processes and to the higher “toxicity” of “dislikes” than “likes” in terms of inciting TMDBs on social media.

Translation, Transcultural Adaptation, and Validation of the Brazilian Portuguese Version of the Body Image Disturbance Questionnaire for Scoliosis (BR-BIDQ-S).

Objective The Body Image Disturbance Questionnaire for Scoliosis (BIDQ-S) for scoliosis derives from the Body Image Disturbance Questionnaire (BIDQ) with specific adaptation for scoliosis patients. Despite its significance and applicability, this instrument has never been translated into Brazilian Portuguese. The current study aimed to translate, transculturally adapt, and validate the BIDQ-S into Brazilian Portuguese. Methods BIDQ-S was translated and culturally adapted into Brazilian Portuguese using the American Association of Orthopedic Surgeons (AAOS) criteria. The questionnaire validation relied on internal consistency and comparison with the Cobb angle, Pediatric Quality of Life Inventory (PedsQL), and Scoliosis Research Society (SRS-22). The Brazilian version (BR-)BIDQ-S validation occurred in a sample of 35 adolescents with scoliosis waiting for specialized treatment. Results Internal consistency of the BR-BIDQ-S was 0.899 according to the Cronbach's index (i.e., virtually perfect). Although BR-BIDQ-S did not correlate with the Cobb angle, it presented correlations with the Physical, Emotional, and Social domains from the PedsQL and the Function/Activity domain from the SRS-22. Conclusion BR-BIDQ-S was reliable in evaluating the body image of adolescents with scoliosis, presenting an internal consistency of 0,899 (virtually perfect). Moreover, similar to the original instrument, it correlated with PedsQL and SRS-22.

Evaluation of pore-fracture microstructure of gypsum rock fragments using micro-CT

This study utilized X-ray micro-computed tomography (micro-CT) to investigate weathered gypsum rocks which can or do serve as a rock substrate for endolithic organisms, focusing on their internal pore-fracture microstructure, estimating porosity, and quantitative comparison between various samples. Examining sections and reconstructed 3D models provides a more detailed insight into the overall structural conditions within rock fragments and the interconnectivity in pore networks, surpassing the limitations of analyzing individual 2D images. Results revealed diverse gypsum forms, cavities, fractures, and secondary features influenced by weathering. Using deep learning segmentation based on the U-Net models within the Dragonfly software enabled to identify and visualize the porous systems and determinate void space which was used to calculate porosity. This approach allowed to describe what type of microstructures and cavities is responsible for the porous spaces in different gypsum samples. A set of quantitative analysis of the detected void and modeled networks provided a needed information about the development of the pore system, connectivity, and pore size distribution. Comparison with mercury intrusion porosimetry showed that both methods consider different populations of pores. In our case, micro-CT typically detects larger pores (> 10 μm) which is related to the effective resolution of the scanned images. Still, micro-CT demonstrated to be an efficient tool in examining the internal microstructures of weathered gypsum rocks, with promising implications particularly in geobiology and microbiology for the characterization of lithic habitats.

Role of TBX20 Truncating Variants in Dilated Cardiomyopathy and Left Ventricular Noncompaction.

Less than 40% of patients with dilated cardiomyopathy (DCM) have a pathogenic/likely pathogenic genetic variant identified. TBX20 has been linked to congenital heart defects; although an association with left ventricular noncompaction (LVNC) and DCM has been proposed, it is still considered a gene with limited evidence for these phenotypes. This study sought to investigate the association between the TBX20 truncating variant (TBX20tv) and DCM/LVNC. TBX20 was sequenced by next-generation sequencing in 7463 unrelated probands with a diagnosis of DCM or LVNC, 22 773 probands of an internal comparison group (hypertrophic cardiomyopathy, channelopathies, or aortic diseases), and 124 098 external controls (individuals from the gnomAD database). Enrichment of TBX20tv in DCM/LVNC was calculated, cosegregation was determined in selected families, and clinical characteristics and outcomes were analyzed in carriers. TBX20tv was enriched in DCM/LVNC (24/7463; 0.32%) compared with internal (1/22 773; 0.004%) and external comparison groups (4/124 098; 0.003%), with odds ratios of 73.23 (95% CI, 9.90-541.45; P<0.0001) and 99.76 (95% CI, 34.60-287.62; P<0.0001), respectively. TBX20tv was cosegregated with DCM/LVNC phenotype in 21 families for a combined logarythm of the odds score of 4.53 (strong linkage). Among 57 individuals with TBX20tv (49.1% men; mean age, 35.9±20.8 years), 41 (71.9%) exhibited DCM/LVNC, of whom 14 (34.1%) had also congenital heart defects. After a median follow-up of 6.9 (95% CI, 25-75:3.6-14.5) years, 9.7% of patients with DCM/LVNC had end-stage heart failure events and 4.8% experienced malignant ventricular arrhythmias. TBX20tv is associated with DCM/LVNC; congenital heart defect is also present in around one-third of cases. TBX20tv-associated DCM/LVNC is characterized by a nonaggressive phenotype, with a low incidence of major cardiovascular events. TBX20 should be considered a definitive gene for DCM and LVNC and routinely included in genetic testing panels for these phenotypes.

Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow-up through 2021.

To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. The high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.

Comparison of hospital rating websites among each other and with data from hospital quality reports and quality assurance based on routine data

In addition to the objectifiable treatment quality, patients' perspectives are gaining relevance. This study aimed to characterize available hospital rating websites (HRW) with regards to patient ratings and to compare them with data from hospital quality reports and quality assurance based on routine data (QSR) for urological departments. After astructured online search for HRWs, websites were compared based on patient ratings from the 10urologic departments with the largest intervention rates in 2021 using generalized estimated equations. For radical prostatectomy (RPE), quantitative comparison of patient ratings (klinikbewertungen.de) and QSR-based ratings was performed using Spearman's rank correlation. Of 1845hits, 25portals were analyzed. The department-wise comparison of HRWs resulted in significantly different patient ratings (p < 0.001). Patient ratings (klinikbewertungen.de) and QSR data (AOK-Gesundheitsnavigator) showed no significant correlation. An internal comparison of QSR data and patient ratings from the AOK-Gesundheitsnavigator on RPE showed asignificant negative correlation between the overall rating and unplanned reoperations (r = -0.81) or other complications (r = -0.91). There was no significant correlation with the recommendation rate by patients. Hospital rating websites show considerable heterogeneity regarding patient ratings of the same urology department in different portals. Furthermore, based on the selected examples, there seems to be no correlation between subjective and objective evaluations between different websites or within one website.

Internal and International Comparison of Breast-Q REACT, a Real-Time Engagement and Communication Tool, for Autologous Breast Reconstruction

Internal and International Comparison of Breast-Q REACT, a Real-Time Engagement and Communication Tool, for Autologous Breast Reconstruction